Provider Demographics
NPI:1891981940
Name:DELA PAZ, TALA MARIA ALCANTARA (MD)
Entity Type:Individual
Prefix:
First Name:TALA MARIA
Middle Name:ALCANTARA
Last Name:DELA PAZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 AKRON GENERAL AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44307-2432
Mailing Address - Country:US
Mailing Address - Phone:330-344-6015
Mailing Address - Fax:330-344-6820
Practice Address - Street 1:1 AKRON GENERAL AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2432
Practice Address - Country:US
Practice Address - Phone:330-344-6015
Practice Address - Fax:330-344-6820
Is Sole Proprietor?:No
Enumeration Date:2007-09-22
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-125540207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0118043Medicaid
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH3600271OtherAKRON GENERAL MEDICAL CENTER MEDICARE GROUP #
OH0454744OtherAKRON GENERAL INTERNAL MEDICINE CENTER OF AKRON MEDICAID #
OH1821035940OtherAKRON GENERAL MEDICAL CENTER TYPE 2 NPI #
OH0118043Medicaid